Does major depression in patients with gastroesophageal reflux disease affect the outcome of laparoscopic antireflux surgery?

Abstract

Even if they are good surgical candidates from a physiologic point of view, GERD patients with concomitant major depression should be selected carefully. In these patients, LARS can normalize physiologic data, but some patients have demonstrated less symptomatic relief, suffered from postoperative dysphagia, and showed less quality-of-life improvement. Eventually, laparoscopic Toupet fundoplication used with these patients could result in a better subjective outcome.

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

“…Furthermore, the experts pointed out the importance of the preoperative QoL assessment for patient selection for laparoscopic surgery in specific diseases. This is especially true for GERD, for example, when deciding on surgery for depressed patients [55].…”

“…In GERD, more than in other diseases, QoL assessment is very important for patient selection in routine practice. Kamolz et al [55] have shown that some patient populations, such as those with major depression, showed less QoL improvement than other groups of patients, despite normal physiologic postoperative data.…”

Review article: gastro‐oesophageal reflux disease and psychological comorbidity

“…44 Psychiatric comorbidities in patients with GERD or stress-related symptoms were shown to affect outcome of 'successful' antireflux surgery. Kamolz et al 45 showed that in GERD patients with coexisting major depression, laparoscopic antireflux surgery achieved a physiological outcome comparable to that of patients who had no psychological comorbidity. Despite this physiological improvement, some patients with major depression felt that their symptoms were not adequately treated, even though their assessment score significantly improved.…”

The impact of gastroesophageal reflux disease on quality of life

“…Several studies have shown that stress-related symptomatology in GERD patients [53] and different comorbidities, such as psychiatric disorders [54][55][56], dyspepsia, or aerophagia [57,58], can affect outcomes negatively. All these studies show that symptom relief of GERD is more complex than just correcting the pathophysiology of the disease.…”